Aligned with our commitment to excellence in health care education, Harris College
delves into the factors influencing prescription drug spending.
We spoke with Associate Professor of Professional Practice in nursing and adult-gerontology nurse practitioner Kimberly Posey, Ph.D., DNP, AGPCNP-BC, GS-C, to examine the top medications consumed, the introduction of new products and fluctuations in drug price to gain valuable insights into the evolving needs of our communities.
What does the current state of prescription drug spending indicate about national health and treatment methods?
Posey: The increase in prescription drug spending suggests significant national health issues and highlights the need for a shift towards preventive care. Investing in preventive measures can reduce the reliance on prescription medications, which are often used to manage preventable conditions.
Why are certain drugs like adalimumab (Humira) and apixaban (Eliquis) becoming more prevalent despite the availability of biosimilars?
Posey: The expiration of patents for drugs like adalimumab and apixaban has opened the market to increased competition. This competition typically leads to lower costs for these drugs, making them more accessible and affordable. Consequently, more insurance plans may cover these cost-effective alternatives, further driving their utilization. As generic versions become available and more widely accepted, we can expect to see a rise in their use.
Do you think the way we manage health with prescription drugs will change soon?
Posey: Significant changes are unlikely soon due to the fragmented U.S. health care system. Instead of focusing solely on treatment, efforts should shift towards disease prevention by improving access to healthy food, exercise spaces and wellness programs.
Will the introduction of more anti-obesity drugs lead to significant price reductions?
Posey: It’s a challenging question whether the competition among anti-obesity drugs will lead to significant reductions in out-of-pocket costs for consumers. Despite the introduction of more competitors, prices remain high, often exceeding $1,000 per month. This price point remains unaffordable for many U.S. consumers. The main issue is whether the increasing market competition will effectively drive down these costs, which has yet to be seen significantly.
How might starter doses of new medications impact overall drug pricing?
Kimberly Posey: One example is with Wegovy, a prescription injectable medication for adults with obesity or overweight and weight-related health conditions. Its initial doses were restricted due to shortages caused by high demand. Now, as production has increased and starter doses have become more available, those with commercial insurance might see an increase in coverage. However, for those who are uninsured, significant reductions in the cash price of Wegovy are unlikely.
What measures can be taken to reduce the prices of prescription drugs?
Posey: To reduce drug prices, a key strategy is government regulation. By enabling programs like Medicare to negotiate directly with pharmaceutical companies, significant purchasing power can be leveraged to secure more reasonable prices. This approach, made possible by the Inflation Reduction Act, allows Medicare to negotiate prices for high-cost drugs, potentially serving as a model for other parts of the U.S. health care system. Initially, the Centers for Medicare & Medicaid Services (CMS) has chosen 10 drugs for these negotiations. Additionally, promoting preventive medicine can also lower drug costs. By focusing on prevention, the need for high-cost drugs decreases as fewer individuals require treatment for preventable conditions.
Harris Talks is a thought leadership series where our faculty experts tackle pressing questions on current health care topics. This series enriches our health care education and practice, equipping our students with the knowledge to effectively address complex health challenges.